膈肌电刺激联合阈值压力负荷呼吸训练对亚急性期颈段脊髓损伤患者肺功能的影响  

Effects of low frequency electric stimulation on diaphragmatic muscle combined with threshold inspiratory muscle training on lung function in patients with sub-acute traumatic cervical spinal cord injury

作　　者：黄乐乐 刘孟 HUANG Lele;LIU Meng(Department of Critical Care Medicine,the First Affiliated Hospital of Bengbu Medical University,Bengbu,Anhui 233004,China;不详)

机构地区：[1]蚌埠医科大学第一附属医院重症医学科,安徽蚌埠233004 [2]中国科技大学附属第一医院康复医学科,安徽合肥230001

出　　处：《中华全科医学》2024年第7期1112-1115,共4页Chinese Journal of General Practice

基　　金：安徽省临床医学研究转化专项基金项目(202304295107020073)。

摘　　要：目的观察亚急性期创伤性颈段脊髓损伤患者进行膈肌低频脉冲电刺激联合阈值压力负荷呼吸训练对患者肺功能和肺部感染发生率的影响。方法采用随机数字表法将2020年7月—2022年6月蚌埠医科大学第一附属医院收治住院的亚急性期创伤性颈段脊髓损伤患者40例分为对照组(20例)和实验组(20例),对照组在常规治疗的基础上接受阈值压力负荷呼吸功能训练,实验组在对照组的基础上给予膈肌低频脉冲电刺激。分别于治疗前及治疗3周后评估患者肺功能[用力肺活量(FVC)、FVC占预计值的百分比(FVC%pred)、第一秒用力呼气容积(FEV_(1))及FEV_(1)占预计值的百分比(FEV_(1)%pred)]的变化;治疗后随访3个月,统计肺部感染的发生率。结果与治疗前比较,2组患者治疗3周后的FVC、FVC%pred、FEV_(1)及FEV_(1)%pred均有明显提高(P<0.01);治疗3周后,实验组患者FVC、FVC%pred、FEV_(1)及FEV_(1)%pred均高于对照组,差异有统计学意义(P<0.01)。治疗3个月后,实验组患者的肺部感染发生率为50.0%(10/20),对照组为80.0%(16/20),实验组患者肺部感染发生率显著低于对照组(χ^(2)=3.956,P=0.047)。结论膈肌低频脉冲电刺激联合阈值压力负荷呼吸训练能有效改善亚急性期创伤性颈段脊髓损伤患者的肺功能,降低肺部感染的发生率。Objective To observe the effectiveness of low frequency electric stimulation on diaphragmatic muscle combined with threshold inspiratory muscle training on lung function and incidence of lung infections in patients with sub-acute traumatic cervical spinal cord injury.Methods A total of 40 patients with sub-acute traumatic cervical spinal cord injury in Department of Critical Care Medicine of the First Affiliated Hospital of Bengbu Medical University from July 2020 to June 2022 were assigned to the control and experimental groups(20 for each group)by the random number table.The control group received threshold inspiratory muscle training on the basis of conventional treatment,and the experimental group was given low frequency electric stimulation on diaphragmatic muscle on the basis of the control group.The patients'lung functions[forceful lung volume(FVC),FVC as a percentage of the predicted value(FVC%pred),first-second forceful expiratory volume(FEV_(1)),and FEV_(1) as a percentage of the predicted value(FEV_(1)%pred)]were evaluated before and after 3 weeks of treatment.The incidence of pulmonary infections was followed up at 3 months after treatment.Results After three-week training,compared with before the training,FVC,FVC%pred,FEV_(1) and FEV_(1)%pred in two groups obviously improved(P<0.01).Comparing with the control group,FVC,FVC%pred,FEV_(1) and FEV_(1)%pred in experimental group were significantly high(P<0.01).After 3 months of treatment,the incidence of lung infection was significantly lower in the experimental group than in the control group[50.0%(10/20)vs.80.0%(16/20),χ^(2)=3.956,P=0.047].Conclusion Low frequency electric stimulation on diaphragmatic muscle combined with threshold inspiratory muscle training can significantly improve on lung function in patients with sub-acute traumatic cervical spinal cord injury,and its effect is better than the simple respiratory training.

关 键 词：低频脉冲电刺激 阈值压力负荷呼吸训练 颈段脊髓损伤 肺功能 

分 类 号：R651.2[医药卫生—外科学] R454[医药卫生—临床医学]